Healthcare Provider Details

I. General information

NPI: 1982522322
Provider Name (Legal Business Name): TRINITY INTEGRATED HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2702 N 3RD ST STE 3000
PHOENIX AZ
85004-4607
US

IV. Provider business mailing address

2702 N 3RD ST STE 2005
PHOENIX AZ
85004-4606
US

V. Phone/Fax

Practice location:
  • Phone: 480-589-6692
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CLEMENT AGBOOLA
Title or Position: OWNER
Credential:
Phone: 480-589-6992